Individual
ERIC PORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5959 INDEPENDENCE AVE, BRONX, NY 10471-1222
(718) 796-4200
(718) 874-9871
Mailing address
5959 INDEPENDENCE AVE, BRONX, NY 10471-1222
(718) 796-4200
(718) 874-9871
Taxonomy
Speciality
Code
Description
License number
State
374T00000X
Religious Nonmedical Nursing Personnel
Primary
—
—
376G00000X
Nursing Home Administrator
—
—
Other
Enumeration date
04/06/2015
Last updated
04/06/2015
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